Objective To evaluate the viability of Cryptococcus in cerebrospinal fluid of patients with cryptococcal meningitis.Methods Electron microscopy,animal inocul ation and neutral red staining of the cere-brospinal fluid specimens were empl oyed.Results Transmission electron microscopy r evealed intact cells and budding cells of cryptococcus which appeared frequently during the early treatment.Edema of cytoplasm and d isar-rangement of structure of capsule we re often found during the later thera py.All mice inoculated experimenta lly with the cerebrospinal fluid specimens were positive on direct examination b ut negative in routine culture were i nfected.A definite number of deep blood-red fu ngal cells were observed in many spec imens.Conclusion These findings add a new approach for dynamic studying o f the viability of Cryptococcus in cerebrospinal fluid of patients with Crypto-coccal meningitis and provide an imp ortant parameter for evaluating therapeutic effect.

Polymerase chain reaction(PCR) was used for the first time in China for the diagnosis of cryptococcal meningitis by amplification of specific sequence of the rDNA genes of C.neoformans.All 11 strains of C.neoformans yielded a specific 136 bp fragment but 21 non-C,neoformans strains did not. The sensitivity of the amplification was about 10 cfu.With the aid of the rDNA-PCR,23 of the 23 cere- brospinal fluids (CSF) specimens which had been confirmed C.neoforrnans positive by smear and/or cul- ture were PCR-positive(100%),and 13 of the 14 CSF specimens which had been confirmed C.neofor- mans negative by smear and culture were PCR-negative (93%).The results of the present study suggest that rDNA-PCR is a sensitive and specific method for rapid diagnosis of cryptococcal meningitis.

Objective: To establish a highly effective transformation method of Cryptococcus neoformans. Methods: Special reagents was used to make C. neoformans take in external DNA under given condition. This chemical transformation result was compared with that of electrotransformation. The feasibility of this chemical transformation was tested by plasmid stability test. Results: The efficiency of this chemical transformation was more than 103 transformants/?g plasmid DNA, far more than that of the traditional electrotransformation. Conclusion: An appropriate transformation method is established for C. neoformans transformation, which has high transformation efficiency.

Objective To observe the clinical efficacy and safety of gahapentin in the treatment of postherpetic neuralgia. Methods A multicenter, randomized, double-blind, placebo-controlled, parallel design, 6-week study was performed. Patients with postherpetic neuralgia were recruited into this study and randomly divided into two groups to receive gabapentin or placebo 1800 mg daily in three divided doses with a forced titration schedule, respectively. The primary efficacy measure was change in the pain score based on a visual analogue scale from baseline to the final week of therapy, and secondary measure was the improvement in sleep quality scored on a 5-point severity scale. Efficacy and safety evaluation was performed at baseline, and 1, 3, and 6 weeks atter the treatment. Results One hundred and forty-one patients were recruited in four clinical centers, and 125 patients completed the trial, of whom 66 were in the treatment group and 59 in the control group. An improvement was observed in both pain scores and sleep scores on week 1, 3 and 6 in both two groups, and the improvement was greater in gabapentin-treated group than that in the control group. The response rate was 29.58% and 57.75%, respectively in gabapentin-treated group on week 1 and 3, com-pared to 13.04% and 40.58%, respectively, in the control group (t = 5.94, 4.12, respectively, both P ＜0.05).Gabapentin was well tolerated, and the most common adverse events were dizziness, vertigo, somnolence and transient abnormality of hepatic function. Conclusion Gabapentin could markedly reduce pain intensity and improve sleep quality with a low incidence of adverse events in patients with postherpetic neuralgia.

Objective To discuss the malaria control strategy and its effects in different stages during past 30 years, and search anti-malaria measures fit for the current situation. Methods The historical anti-malaria and epidemical data in Jiangsu Province during the past 30 years were collected and analyzed. Results 6216128 malaria cases were reported in the province in 1973, and the incidence was 1136.34/10000. Through the five anti-malaria stages in past 30 years, the epidemic has been effectively controlled gradually. Six hundred and thirty-eight malaria cases were reported in the province in 2003, and no individual locally infected with P.falciparum was found for 16 successive years. Conclusion The anti-malaria strategy of the five stages is basically suitable for the actual situation of malaria control in Jiangsu Province.

Objective To establish a fast and sensitive method to detect Plasmodium sporozoites in mosquitoes. Methods Anopheles anthropophagus (An.a) artificially infected with Plasmodium vivax (P.v), Anopheles dirus (An.d) infected with Plasmodium falciparum (P.f) and both of P.v and P.f, field mosquitoes of Anopheles sinensis (An.s) captured in epidemic seasons were detected by nested-PCR. Results The results of 28 batches of An.a infected with P.v, 2 batches of An.d with P.f and 1 batch of An.d mixed with P.v and P.f by nested-PCR were accorded with the microscopical examination absolutely. Two positives of 589 An.s field mosquitoes were discovered with a positive rate of 0.34%. Conclusion The nested-PCR is fast and sensitive for detecting different species of Plasmodium in mosquitoes.

Objective To analyse the epidemic characteristics and control measures of malaria in Jiangsu Province during the past fifty years, evaluate the control effect and explore the current appropriate control strategy and measures. Methods The historical data about malaria cases and control measures from 1951 to 2008 in Jiangsu Province were collected, and the effects of malaria control in different stages were assessed. Results The integrated control measures with emphasis on the control of infectious source were adopted during the stage of two outbreaks of malaria. In the stage of basical elimination of malaria, the comprehensive measures with emphasis on the vector control in the areas of Anopheles anthropophagus were adopted, and the measures with emphasis on the surveillance of infectious source surveillance and early treatment of malaria in other areas were adopted. In the stage of consolidation, the measures including the surveillance of infectious source and management, surveillance of vector and epidemic situation, management of floating population, etc, were adopted. The malaria incidence dropped from 2 495/10 000 in 1960 to 0.09/10 000 in 2008, and was under 1/10 000 in all the counties of Jiangsu Province during the past 2 years, which demonstrated the various measures were feasible and effective in different stages of malaria. Conclusions Malaria has been controlled effectively in Jiangsu Province, however, the improvement of early diagnosis and norm treatment of malaria cases, the enhancement of health education and promotion, as well as the malaria surveillance and management among floating population, are still necessary for achieving the goal of malaria elimination.

Objective To observe the residual effect of Demand CS - impregnated bednets to Anopheles sinensis.Methods The numbers of adult mosquitoes which were knocked down at every minute after treatment were observed by using the enforced contact method recommended by WHO,and the mortality of mosquitoes tested after 24 h was calculated.Results The Kt_(50) of Demand CS - impregnated bednets with impregnations concentrations of 10,15,20 mg/m~2 to Anopheles sineasis were 21.40,16.20,15.70 min,respectively,and the 24 h mortality was 100%.The Kt_(50) of Responsar SC (12.5 % Beta - cyfluthrin) impregnated bednets with a impregnation concentration of 15 mg/m~2 to Anopheles sinensis was 16.06 min,and the 24 h mortality was 100%,too.Conclusions Both the Demand CS - impregnated bednets and the Responsar SC impregnated bednets can kill Anopheles sinensis.

Objective To examine mycological profile of eryptococcal meningitis in patients with non-acquired immune deficiency syndrome (AIDS) during treatment and follow-up so that to support clinical therapy. Methods Data of 28 cuhure-confirmed cryptoeoccal meningitis patients with non-AIDS were retrospectively analyzed. Fungat smear, count, culture and latex agglutination test of cerebrospinal fluid (CSF) were done during treatment and follow-up. Initial treatment included intravenous amphotericin B plus oral flucytosine or f;uconazole for at least 6 weeks, and consolidation treatment included oral fluconazole and (or) itraeonazole for at least 2 months. All 28 patients were cured. The data were analyzed by rank-sum test. Results The positive rate of CSF fungal smear was 92.9% before treatment and gradually decreased, and the fungal count was significantly reduced over time after treatment. While fungal smears of some patients were still positive after initial treatment. Fungal growth time in culture was gradually extended, and fungal culture turned to be negative in all patients after 2 weeks of treatment. The positive rate of latex agglutination test of CSF was 100%. Cryptococcal antigen titer decreased steadily after treatment, which was not correlated with the decrease of fungal count. Conclusion Mycological tests of patients with eryptococcal meningitis should be interpreted comprehensively during treatment, and result of each test should be specifically analyzed.

Objective To understand the epidemic situation and influencing factors of malaria in Jiangsu Province and grasp its epidemic regularity and trend. Methods According to the malaria prevalence in Jiangsu Province,6 counties(city,dis-trict)including Yixing,Suining,Wujin,Hai’an,Ganyu and Xuyi were selected as provincial surveillance sites to survey malar-ia epidemic conditions. The basic information,blood test results of fever patients,case investigation information of malaria pa-tients,monitoring data of investigation and disposition of the malaria focus were collected and analyzed. Results In 2013,the blood tests of 66 723 fever patients were performed,the average blood smear checking rate was 1.10%,and the average positive rate was 0.08%(52 plasmodium positive individuals)in the 6 areas. For these 52 plasmodium positive individuals,the blood re-tests and case investigations were completed within 3 days after these cases were reported by the network system,and the investi-gation confirmed that they were foreign imported malaria cases. The malaria focus investigation and disposition were finished within 1 week and the data were reported by the Parasitic Diseases Information System. Four of 52 cases were recrudescence dur-ing the follow-up. Among the 52 cases,20 people went abroad themselves and 4 were labors of private enterprises,21 people came back without the accompanied. Conclusions With the development of the malaria elimination program in Jiangsu Prov-ince,the eliminating malaria“targeted 1-3-7”working pattern has been comprehensively implemented. The personnel monitor-ing for labors who returned from overseas working will be a key in the future.